Typically, decision-support algorithms are incorporated into vital-sign monitors and other medical recording systems. This results in the algorithms being proprietary to the manufacturer and not facilitating easy modification or refinement by end-users and/or testing of new decision-support algorithms by either the manufacturer or the end-users.
Most of the existing literature discusses research in the decision-support area that uses retrospective analysis of previously gathered data to test and refine decision-support systems located on workstations and/or servers.